Effect of Matrix Metalloproteinase-2 Inhibiotr Doxycycline on Incisional Hernia Recurrence Rates in ADM or Polypropylene Mesh Implanted Rate Incision Hernia Model

An incisional hernia is one of the most common complications of laparotomies, occurring annually in 10 to 15% of patients and up to 30% in certain subgroups of patients (Kingsnorth, 2006, Raffetto et al., 2003). This causes billions of dollars in lost productivity for patients and increased expense for health care systems. Even after an incisional hernia repair, the possibility of recurrence is as high as 54% depending on the technique used to repair (den Hartog et al., 2008). In some patients, incisional hernias result in bowel incarceration, obstruction, and strangulation. This study seeks to elucidate the effect of doxycycline on wound healing and incision hernia repair at cellular and tissue levels in a rat incision hernia model. The current proposal aims to study the effectiveness of combining the usage of a well-known prosthetic mesh, Acellular Dermal Matrix (ADM), and doxycycline, a tetracycline derivative known to inhibit matrix metalloproteinase-2 (MMP-2) (Gulub et al., 1991, Uitto et al., 1994). A midline laparotomy will be performed on the rats to create a hernia defect in rats as detailed in Roth et al., 2009. The rats will then be fitted with either of two different types of prosthetic membranes commonly used in hernia repair surgeries: a synthetic monofilament polypropylene mesh or an acellular dermal matrix (ADM), which is of human origin. Successful completion of this project has the potential to pave the way to a therapeutic intervention of incisional hernia formation and also shed light on the complex cellular signaling pathways related to herniation.